J Trauma
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We aimed to study the relationship between the number of fractured scapular regions, and the severity and distribution of associated injuries in blunt trauma patients. ⋯ Associated injuries are common in patients with scapular fractures. ISS and Abbreviated Injury Scale score for chest injuries are higher and posterior structure injuries are more frequent in patients with fractures involving multiple scapular regions.
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To identify significant demographic, clinical, and nonclinical factors among elderly persons influencing the discharge location after hospitalization resulting from a traumatic fall. ⋯ Gender, race, payment type, body region injured, Injury Severity Score, physiologically based Emergency Department Revised Trauma Score, and need for intensive care unit care were significant predictors of discharge location. Understanding and addressing the factors found in this study can improve the discharge planning process and posttreatment management.
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Comparative Study
Experimental study of controlled fluid resuscitation in the treatment of severe and uncontrolled hemorrhagic shock.
Hemorrhagic shock is a common clinic emergency case. The fluid resuscitation method in the presurgical care of hypotensive trauma patients is open to debate. This study was conducted to evaluate the general and pathophysiologic effects of controlled fluid resuscitation in the treatment of severe and uncontrolled hemorrhagic shock. ⋯ In severe and uncontrolled hemorrhagic shock, some fluid must be given in proper time to improve tissue perfusion and avoid early death. Among three fluid resuscitation methods, controlled fluid resuscitation can effectively decrease additional blood loss, avoid excessive hemodilution and coagulopathy, improve the early survival rate, and reduce the apoptosis of visceral organs in rats with severe and uncontrolled hemorrhagic shock. This model supports the concept that when surgical care is not readily available, controlled fluid resuscitation should be considered in the treatment of uncontrolled hemorrhagic shock.
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In Mexico and most other Latin American countries, many emergency medical services (EMS) systems rely on employees and volunteers with only on-the-job training and without formal Emergency Medical Technician (EMT) certification. This study sought to evaluate the costs and effectiveness of providing EMT certification to all personnel working in an EMS service in a Mexican city. ⋯ These data support the promotion of policies that require and enable EMT certification for all prehospital care providers in Mexico and potentially also in other Latin American and other middle-income developing countries.